Sepsis Flashcards
How is sepsis defined in the Sepsis 3 study?
A life threatening organ dysfxn caused by dysregulated host response to infection
What is the Sepsis-3 definition of septic shock?
Septic shock is defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities substantially increase mortality. sepsis with persisting hypotension requiring vasopressors to maintain MAP ≥ 65mmHg and serum lactate ≥ 2mmol/L despite adequate volume resuscitation
What is the qSOFA score
- Resp rate >22
- ALOC
- SBP
What does the qSOFA score predict?
identifies patients at risk of sepsis
2+ criteria identify patients at increased risk of ICU stays of 3+ days or in hospital mortality
What are the elements of the SOFA score
PF ratio platelets Bilirubin MAP GCS Cr Urine output
List differential for sepsis and septic shock
Sepsis dehydration ARDS anemia ischemia hypoxia CHF vasculitis tox pancreatitis hypothalamic injury DIC anaphylaxis hyperthyroidism DKA adrenal dysfunction trauma NMS
Septic Shock
Hypovolemic shock acute blood loss severe dehydration cardiogenic shock PE MI pericardical tamponade tPTX vasogenic shock anaphylaxis paralysis
What are potential sources to consider in sepsis
o UTI § Complicated pyelonephritis / perinephric abscess o CNS: § CSF § Epidural abscess – spine or intracranial o Open wounds o RTI: § Respiratory secretions § Empyema o Cardiac: § Infective Endocarditis o GI § Stool § Intra-abdominal infections · C. difficile · Ischemic gut · Perforated viscus · Abscess · Ascending cholangitis · Gangrenous cholecystitis · Necrotizing pancreatitis o Indwelling lines and catheters o Soft tissue and Joints: § Necrotizing soft tissue infections § Septic arthritis